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Antiviral Therapy for Herpes Simplex Virus Encephalitis: Systematic Review and Meta Analysis of RCTs
20 Pages Posted: 8 Mar 2019More...
Background: Herpes simplex virus (HSV) infection of the brain is treated with antiviral drugs like Acyclovir. A summary of randomized control trials of antiviral drugs against HSV encephalitis has not been put forward yet.
Objectives: To determine the effect of antiviral agents in the treatment of HSV encephalitis on mortality and neurological sequelae at approximately two years. The secondary objective was to assess the adverse effect of antiviral agents on the patients.
Search methods: Trials were identified by searching the PUBMED, European Medical Agency, USFDA, US Clinical trials, Elsevier database and Cochrane website and the reference lists of published trials.
Selection criteria: Randomized controlled trials of antiviral therapy in biologically proven HSV infection was included.
Main results: A total of 5 studies met the criteria. The first study was published in 1980 and the latest was in 2015. All the studies used acyclovir/valacyclovir or vidarabine. Three studies compared acyclovir and vidarabine, one study was placebo controlled vidarabine trial and another one was a placebo controlled trial of long term valacyclovir therapy. Acyclovir improved mortality and lowered the incidence of neurological sequelae. There was no significant reduction in the risk of mortality with vidarabine therapy.
Authors' conclusions: Trial evidence suggests that acyclovir decreases mortality and morbidity in acute HSV encephalitis.
Declaration of Interest: None.
Suggested Citation: Suggested Citation